State-Specific Medicaid/CHIP Eligibility Criteria and Their Impact on Health Care Access for Foreign-born Children Living in the United States.

Abstract

Foreign-born children are subject to discrepant state policies in determining eligibility for Medicaid/Children's Health Insurance Program (CHIP) coverage. The objective of this study was to determine the effect of these policies on health care access. Data from the National Survey of Children's Health (NSCH) were used to assess associations between health care access outcomes and three categories of state health insurance eligibility: restrictive (only U.S. citizens plus immigrants who "qualified" after five-year waiting period), semi-restrictive (same as restrictive except no waiting period), and inclusive (all children). When compared with restrictive states, foreign-born children in inclusive states were significantly more likely to have current insurance, consistent coverage, recent preventive exams, and fewer problems paying medical bills. Extending health care eligibility to all children, regardless of immigration status, improves health care coverage and access for foreign-born children. Expansion of eligibility criteria in all states is necessary to reduce health disparities in the immigrant population.